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Permit ��;� CITYOFTIGARD RESTRICTED ENERGY m DEVELOPMENT SERVICES ELECTRICAL PERMIT - PERMIT #: ELR2004 -00287 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 9/9/2004 SITE ADDRESS: 13221 SW 68TH PKWY 460 PARCEL: 2S101 DA -00102 SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE BLOCK: LOT: 002 JURISDICTION: TIG Project Description: Limited energy A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: ROBINSON, ROY ESP TECHNOLOGIES 2655 SEELY AVE. 7929 SW BURNS WAY STE. F SAN JOSE, CA 95134 WILSONVILLE, OR 97070 Phone: 408 - 943 -1234 Phone: 408 - 943 -1234 Reg #: Lt/'3- 6287' 2 ELE 34- 269CLE FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 9/9/2004 $75.00 Elect! Final [TAX] 8% State Surchart 9/9/2004 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions . • UNC - • 246 -6699. Issued by Permittee Signatur- , OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day Electrital Permit ARNEIVED FOR OFFICE USE ONLY City of Tigard Received : Permit No.: LC11 '-1 00 13125 SW Hall Blvd., Tigard, OR 97223 e LI 0 9 2004 Plan Review Phone: 503.639.4171 Fax: 503.598.1960) / l >,v17, �•; j � I' `-. DateB : Other Permit: Inspection Line: 503.639.4175 ^ e + ^ -•JI . Date Ready/By: EMI ® See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGAR "" - Notified/Method: Supplemental Information INN DIVISION t ' OF WORIC ti ;_ r•.<. PI AN'REYIEW'1' ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 as - rating ❑ Buildng over 10,000 sq. ft., <S ` ` ' - - , CATEGORY= , OF COMST iCTPION ^ '" t • ";' i ; ; " : ' " of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ri ommer ci al/industri al ❑ Accessory building ['System over 600 volts nominal units in one structure ❑Building over three stories ❑Feeders, 400 arnps or more ❑ Multi - family ❑Master builder ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or .. :' t ,r OB J-�'E„ 'QRMATION AND LOCA _ TION .. -,.. , ":"',1- , ❑Egress/lighting plan RV park Job no.: o4 U . i 1 Job site address:13 )20.1 cup L ? a1A i-(4,0 ❑Health care facility ['Other: Submit 2 sets of plans with any of the above. City/State/ZIP: 4 vcriz Dye, a 3 S The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: v Project name: A s ;FE*`_ �* D ; G Yom. PP, A Description I Qty. I Fee. I Total I •* Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: • Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 . ` , DESG'RIPTION OF WORK - _ ,. s' : Each manufactured or modular (.6C_, `� I - „� y �� dwelling, service and /or feeder 90.90 2 V ©t W Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 •- ' • - 201 amps to 400 amps 106.85 2 1:1 :PROPERTY, OWNER'' ,- s'El TENQNT,. :i = ";: • .F• 401 amps to 600 amps 160.60 2 • Name: Ai, kc.,k`4 v � 601 amps to 1,000 amps 240.60 2 Address: -L� - " Over 1,000 amps or volts 454.65 2 `� ° � ` ( Reconnect only 66.85 2 City /State /ZIP: o a(Q_N CZ--47 q'.) -S Temporary services or feeders installation, alteration, and/or Phone: ( ) Fax: ( ) 1 � relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 _ 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ❑ AtPPLICANT .' c,,..:' , .' - ." ❑ . CONTACT PERSON . A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax :: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- - ' CONTRACTOR ,. s . energy panel, alteration, or Business name: G ,. ( 0 j E-G extension. Describe: \ Page 2 1 S ....ca) 2 G f , , _ Address: �_` q.../ E _ ���v\ 5 � � Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: W \C ..‘` i r) \ \ I c_ (C7 q 0-) () Investigation per hour (1 hr min) 62.50 Phone: ! ' Fax; Industrial plant per hour 73.75 ( Sb (�`� 01 — -{,L 5 ( b 3 `a - `� 7 l ; . - - EtECratoiL PEItMI'r PEES* ' CCB Lic.:1,? -7 e.. I Electrical Lic.:3q.. Goad Suprv. Lic.: 2781L Subtotal -1S , • Suprv. Electrician signature, required: ... Plan review (25% of permit fee) Print name: State surcharge (8% of permit fee) <s (p Q C O � 1 � � � l ` Lv,f ,' TOTAL PERMIT FEE 1 O Authorized signature: 'r' 7 1 This permit application expires if a permit is not obtained within 180 � /,∎,- days after it has been accepted as complete illA /IV Print name: -r Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. i:\ Bui lding\Pemits\E1.C- PemMApp.doc 12/03 440.4615T(IO /02/COM/WEB Electrical Permit Application - City of Tigard . . Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: ' Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: X53. Fee for each commercial system $75.00 (SEE OAR 918 - 260 - 260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i: Buildineermits \ELC- PennitApp.doc 04/03 CITY OF TIGARD 24-Hour BUILDING Inspection 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested — / 4 AM ` PM BUP Location 1 a- a` ( L f kC td! Suite `7-�v 0 MEC Contact Person Ph ( O ) ° 75 ? 0 7 1 0 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: p Ftg Drain ELR �Dn� A ? D 7 Crawl Drain Slab Inspection Notes: SIT Post & Beam Ext Shear Sheath/Shear th /SSh ear .MO Ext eah/h Int Sheath/Shear Framing Insulation q� / y —� 1) i rz �. / Drywall Nailing D7 / �z -- go w Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling • Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: .. Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Se .' •ugh -In .ctkl.b ow Volt Fire : larm 441!» 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PART FAIL Please call for reinspection RE: Unable to inspect — no access Fire Supply Line C� / ADA Date I l I� V Inspector . xottliptotEeem_yExt Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL